Sexual abuse ranges from being touched inappropriately even one time, to ongoing abuse in a family, to kidnap and rape, to sex exploitation on the Internet.

“I don’t think there’s anything else that can happen to a human being that’s more devastating than being abused as a child, considering the range of symptoms and the impact on life,” said Janice Palm, the executive director of Shepherd’s Counseling Services on North Capitol Hill. “Psychologically and emotionally, it universally affects how people trust.”

Sexual-abuse victims of any age experience similar psychological consequences. Disorganization, difficulty concentrating, even post-traumatic stress disorder (PTSD) is the same for children and adults, said Christiane Elsbree, a therapist in the Roosevelt neighborhood: They will act out, get into fights and be either hyper-sexualized or avoidant of physical contact.

Adults survivors may encounter depression and isolation, numbness to feelings, anxiety, alcohol and drug dependence, high-risk-taking behaviors, a history of abusive or “unsatisfactory” relationships, intense feelings of rage or questions about their sexual orientation, according to Bellevue therapist Marc Gilmartin.

“Not every [abused] kid needs [extensive counseling services]. A lot of kids are exposed to sexual abuse; it doesn’t mean they’ll have long-lasting trauma — a third will,” said Lucy Berliner, program director of the Harborview Center for Sexual Assault and Traumatic Stress. “With their parents’ support, there’s no reason to believe they’ll have long-term, lasting effects.

“They need awareness of the big picture: Sexual abuse is not going to be the only thing that happens to them in their lives,” she stated.

Gilmartin added, “Not everyone feels trauma by it — both men and women. What they take away [from the abuse] is what they’ll associate with it.”

— Vera M. Chan-Pool

The recent sexual-abuse scandal at Pennsylvania State University saw all the familiar incubators for the silent epidemic of sexual abuse in this country and abroad: shock, denial, a self-protective, closed institution — in this case, a university orbiting around a football team — and shame and reticence among its victims.

At the time, broadcasters treated the scandal as monumental news, but it’s already faded away.

The real news is that this cycle is nothing new to its victims, who continue to cover up their distress for fear of reprisals: threats toward loved ones, further abuse or public humiliation.

About one out of every four girls and one out of every six boys are sexually abused before age 18. The reality may be higher than the reported statistics.

Victims are usually ashamed of what was done to them, usually at the hands of someone they not only know but also trust. About 30 percent of sexual abusers are family members and about 60 percent are family friends, babysitters, neighbors or other people within the child’s “circle of trust,” according to the U.S. Department of Health and Human Services.

“It happens in secret,” said Janice Palm, executive director of Shepherd’s Counseling Services on North Capitol Hill, which offers therapy solely for adult survivors of childhood sexual abuse. “People who are perpetrators are nice to that child in public. They’re buddies, friends doing fun things.”

Furthermore, there is no visible evidence. “The child appears as if nothing has happened. They’re masking this; they’re coping. It’s a very deliberate effort,” she stated. “They’re terrified [to say anything about it] because there’s so much shame about it to tell anyone. All of that conspires to help with what [we want to see or not see].”

“People are in denial that someone they like and know and admire could do something so heinous,” said therapist Christiane Elsbree, who has an office in the Roosevelt neighborhood. In the mid-‘80s, she counseled victims of the McMartin preschool case in California. “The boundaries get blurred, and the perpetrators groom their victims.”

The Penn State scandal involving assistant football coach Jerry Sandusky brought light to the issue again after years of media inattention following the Catholic Church scandals. But each time, the public’s gaze was focused on the perpetrators and their institutions and not on the numerous victims, many of whom are now adults.

“When you say ‘childhood sexual abuse,’ there’s not a picture that comes to mind that anybody wants to see,” Palm said. “It’s a hard image to grasp; the mind has nowhere to grasp that.… It really is a horrible thing to consider.”

Getting legal justice

Of the sexual-abuse cases investigated in 2011 by the King County Prosecutor’s Office’s, 41 percent of the victims were age 13 to 18 at the time of the incident, 33 percent were age 7 to 12 and 26 percent were 6 and younger, according to senior deputy prosecutor Lisa Johnson, chair of the Special Assault Unit.

A majority of the offenders were age 26 and older (51 percent), with perpetrators age 18 to 25 being the next largest age group, at 19 percent.

Criminal charges aren’t filed in hundreds of cases, Johnson said, because the victim or the victim’s family refused to cooperate with the investigation, there weren’t enough witnesses or evidence to support a charge or it was a “misunderstanding,” as in the cases of young children learning about body parts.

Sexual-abuse cases make up 2.5 percent of the caseload handled in the county, according to King County Prosecutor Dan Satterberg.

Still, the Prosecutor’s Office filed about 400 cases against alleged sexual abusers last year, Johnson said, with minimum sentences starting at 51 months for child molestation (sexual contact without penetration of children under 12) and 93 months for child rape (sexual contact with penetration of children under 12), up to life in prison.

“It’s one of the more serious offenses next to murder, pretty much,” Johnson said.

The King County Prosecutor’s Office did not have statistics about how many of its sexual-abuse cases were successfully fought. But Satterberg stated, “Washington [state] was a leader early on [in sex-offender legislation]; other states are catching up. Ours is as good as any law in the nation.”

Washington state’s statute of limitations allows victims to report childhood sexual abuse up to age 28, depending on the circumstances of the case. A criminal trial may not take place for at least a year and a half, and then the trial could take up to three weeks, during which the victims’ lives are often scrutinized by the defense.

For survivors to go through the legal system, they need to have the “emotional understanding, to have the sense of what was lost and the harm that was done. They need to work through the trauma to go through the process that doesn’t welcome you with [open] arms.… You need to prove it was done to you,” Palm said.

As a result, many childhood incidents of sexual abuse aren’t reported, even in adulthood, or only after the statue of limitations has long passed for criminal cases.

Oftentimes, the victims don’t remember they were sexually abused until much later in life, when something triggers a memory or feeling. In these instances, the only legal recourse would be a civil case.

The state statute of limitations for such cases is three years from the date the abuse or any related injury (such as a physical condition or mental trauma) is diagnosed or discovered.

“It’s the most liberal discovery statute in the country that I know [of],” said Seattle attorney Jo-Hanna Read, a former public defender whose sexual-abuse cases now account for 80 percent of her caseload; many are against the state’s foster-care system, and about a fifth are clients under 21.

Though a low percentage of them go to litigation, a “vast majority of the cases settle,” she said. “Every few years, we go to trial [with a civil case]. My last one was over three years ago.”

Pfau’s firm has successfully litigated high-profile cases against the Catholic and Mormon churches and the Boy Scouts of America, among others, as well as the recent case of a former student sexually abused by a teacher/principal at St. Benedict School in Wallingford in the early ‘60s.

“I tend to see the worst cover-ups in hierarchical, male-dominated institutions,” Pfau said. “Their history has been insular and exclusive, which moves them toward an us-vs.-them mentality.… In secretive institutions, children get hurt.”

He added the programs have improved somewhat: “The [Catholic] Church is better at screening for pedophiles… [But] the rigor with which institutions defend [such] actions has not changed — it’s the same.”

(Clergy members are exempt by law from reporting sexual-abuse incidents, while individuals who have frequent contact with children and young adults — such as child-care providers, school personnel, physicians and social workers — have 48 hours to report such incidents.)

Only about six lawyers in Seattle specialize in childhood sexual-abuse cases, taking them on contingency, the attorneys said.

“It’s not an injury anyone can see,” Read said, so expert testimony is often needed to explain the “profound ways abuse can affect you.”

While “filing a lawsuit can be very empowering,” Read said, “no amount of money in the world will make up for what happened to you.… You need to stand up for yourself and say, ‘This is wrong.’”

Pfau agreed, “Just being heard, regaining the control they lost as children, standing up for your rights is key to the process.”

Outside influences

Victims often keep the secret of their childhood sexual abuse to themselves because of the shame they believe they’ve earned for doing something wrong.

“I don’t think our society really grasps the vulnerability of our children,” Palm said. “We’re still placing the responsibility [of their safety] on the children — that’s misguided. The responsibility has to be on every adult to pay attention.”

The victim’s family and culture may also inhibit them from disclosing the abuse.

“Closed societies definitely have influences,” said Bellevue therapist Marc Gilmartin. “Certain family and ethnic communities have a strong ethos of no snitching.”

“All you have to do is ask,” said Lucy Berliner, program director of the Harborview Center for Sexual Assault and Traumatic Stress and the principal investigator for the University of Washington. “Society has changed very much in the last 30 years. There’s more awareness and prevention classes. It’s not a world where we wouldn’t know [sexual abuse] didn’t happen.”

Sometimes, how the victim is responded to following a report of childhood sexual abuse can be more traumatizing than the abuse itself, Gilmartin said: “They get questioned, blamed.”

Especially for male victims. “There’s a little more acceptance in our culture of knowing a woman has been sexually abused. [But] men are thought of as warriors, protectors…. Men have a different kind of shame,” he said.

About 30 percent of Gilmartin’s clientele are dealing with issues stemming from childhood sexual abuse — 95 percent of whom are male, he said.

Men are also reluctant to report sexual abuse because they may be seen as potential perpetrators themselves.

According to research, one in five survivors goes on to commit sex crimes, while there’s a “much higher correlation with chronic, repetitive, physical violence to [someone becoming] a perpetrator,” Gilmartin stated.

Perpetrators are underdeveloped in intellectual maturity and controlling it, Palm explained: “It’s not going to click for them that it’s the wrong thing to do. But that [alone] doesn’t make everyone perpetrators.”

According to Berliner, the number of cases reported to Child Protective Services has declined more than 50 percent in Washington state and the country, based on recent studies. She theorized that children are now more aware of possible dangers and that potential perpetrators may be deterred by “way more serious criminal consequences.”

“I don’t see that; I haven’t seen that statistic,” Palm countered. “It doesn’t make intuitive sense to me that it’s gone down.… People are more likely to report [incidents] now.”

Learning to heal

The healing process can take years, even decades, from when the abuse was disclosed. Those on the frontline — the therapists and the litigators — say that more can be done to aid that process.

“From my perspective, there shouldn’t be a statute of limitations for sexual abuse,” Read said, conceding that the statute isn’t likely to change. “There’s a strong school of thought that there should be a finality, like with a car-accident case: They don’t want to worry for the rest of their life that they’ll get sued.”

“It’s true there hasn’t been political will behind it,” Palm said. “Compared to domestic violence in the ‘60s and ’70s, nobody talked about it; it was totally behind closed doors. In that trajectory, we’re a couple decades behind.

“Is there a statute of limitations for suffering?” she pressed. “You still need to address it as adults. The effects can be diminished, but they’re not resolved. It takes adult maturity and development to stand back to say, ‘This is what it meant.’”

Aside from the legal aspects of childhood sexual abuse, there also needs to be a societal recognition that it not only exists but that it’s prevalent. The therapists agree that our “sex-phobic” Western culture has prevented us from even talking about basic health issues, much less sexual abuse.

“It’s a matter of recognizing that some people are attracted to little boys and little girls, and they don’t respect moral limits,” Elsbree said.

Sexual abusers “really are that good at hiding what they do. They have the sense of a vulnerable child, who’s needy in some way. They have an under-formed part of them that can sense the extra vulnerability in a child,” Palm added.

While perpetrators can’t be easily identified, people should be aware of adults who prefer the company of children, who make tight, special friendships with kids — “not always, but it raises the red flag for me,” she cautioned.

“Everyone knows what to look for: Don’t disregard the question marks,” she said. “It’s empowering for people to know…that every single member of the community can help. Perpetrators [won’t be] comfortable being here. We can pay attention, don’t minimize, don’t look the other way. It means the safety of kids who live here.”

“It’s never too late to speak up,” Satterberg stressed. “Not only will you help yourself but you will help others who could fall victim.… You could save others down the line.”

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